J Korean Ophthalmol Soc.  2021 Dec;62(12):1617-1625. 10.3341/jkos.2021.62.12.1617.

Adherence Improvement in Glaucoma Patients: Effects of Educational Intervention Using an Eye Drop Chart

• Choi WS
• Kim JH
• Lee CH
• Lee CE
• Seo S

• KMID: 2523315
• DOI: http://doi.org/10.3341/jkos.2021.62.12.1617

Abstract

Purpose
To evaluate the effects of an educational intervention using an eye drop chart and supplementary education on glaucoma patients’ adherence.
Methods
In this multicenter prospective study, medically treated glaucoma patients were educated on the administration of eye drops using an eye drop chart. At the time of recruitment, all of the patients completed a questionnaire on demographic characteristics and adherence. Three months after the initial educational intervention, the patients were randomly divided into two groups: an education group and a control group. The education group received supplementary education. Immediately thereafter and at 6 months, all of the patients completed the questionnaire on adherence again. Changes in instillation behavior, the relationship between the adherence score and demographic characteristics, and factors contributing to an improvement in adherence and intraocular pressure were then analyzed.
Results
The adherence scores were significantly higher in patients with fewer medications, a higher annual income and higher educational level, and an urban residence (p = 0.038, p = 0.033, p = 0.041 and p = 0.047, respectively). Education on the administration of eye drops and use of the eye drop chart improved adherence scores from 23.05 ± 3.52 to 21.30 ± 3.95 (p = 0.021) and significantly reduced the average intraocular pressure from 14.3 ± 2.9 to 12.4 ± 3.1 mmHg (p < 0.001). Working indoors (odds ratio [OR] = 5.47, p = 0.032) and supplementary education at 3 months (OR = 4.53, p = 0.030) were also correlated with improved adherence.
Conclusions
An eye drop chart is an effective tool for improving adherence and intraocular pressure control in glaucoma patients. Improvement in adherence was especially notable in patients whose work predominantly involved indoor activity. The effectiveness of the eye drop chart was improved by supplementary education.

Keyword

Adherence, Education, Eye drop chart, Glaucoma medication